Clinical update

New drug therapy for myeloma

A collaboration between Cancer Drugs Fund and National Institute for Health and Care Excellence has produced a new drug therapy available to some patients with myeloma

A collaboration between Cancer Drugs Fund and National Institute for Health and Care Excellence has produced a new drug therapy available to some patients with myeloma


Picture: Science Photo Library

Essential facts

Myeloma, a cancer that develops from plasma cells in the bone marrow, is diagnosed in approximately 5,500 people in the UK each year. In 2014 it was the reason given for nearly 3,000 deaths. Cancer Research UK statistics show that about a third of patients with myeloma survive for ten years or more.

What’s new?

An innovative immunotherapy drug treatment for myeloma, daratumumab, was recently approved for use in the Cancer Drugs Fund in England and Wales by the National Institute for Health and Care Excellence (NICE). But it will only be available to patients who have had three previous lines of treatment and whose myeloma has since progressed – approximately 700 patients a year. Data gathered will be reviewed in 2020. Daratumumab was approved in Scotland last year.

Signs and symptoms

There may be no symptoms in the early stages of myeloma, or the symptoms may be vague, according to Cancer Research UK. Bone pain is common, and fatigue, infection and anaemia are likely. High calcium levels in the blood, caused by damaged bones, can lead to nausea, vomiting, confusion and drowsiness.

Causes and risk factors

Causes are complex and not fully understood, but myeloma develops when DNA is damaged during the development of plasma cells. Most people affected are over 65 and it is rare in those under 40.

Myeloma is twice as common in black populations as in white and Asian people, and it affects more men than women.

It is also more common in people who have had monoclonal gammopathy of undetermined significance (MGUS). MGUS is an excess of large protein molecules in the blood.

How you can help your patient

Myeloma is a chronic disease so patients require ongoing assessment and evaluation as their condition changes. Myeloma UK says specialist nurses are well placed to assess, monitor and support patients, and to advocate on their behalf.

Expert comment

Ellen Watters, myeloma information nurse specialist, Myeloma UK

'We’re hearing good things about daratumumab, and a lot of patients and families are getting very excited. However, they’re sorely disappointed at the restrictions NICE has put on it.

'It’s not for patients who have had five, six or seven lines of treatment, or even one or two. It’s three lines of treatment only and that’s a narrow window. There’s a huge range of patients who cannot get access to it.

That said, when I first started at Myeloma UK in 2003, there were two or, at most, three treatment options for patients. Now options are numerous. All these new drugs are coming along and clinical research into myeloma is a very busy area. There’s lots happening.'

 

Further information

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